Detox center struggles with funding, space

This past Halloween, two intoxicated students in protective custody spent the night in jail cells, Tim Moran, coordinator of Act One, said.Under standard procedure, publically inebriated individuals in police custody are taken to Act One for a screening, Captain Tim Bilodeau, of UVM Police, said. Act One, located downtown on Pearl Street, is a resource for substance abuse treatment and detox. Due to high traffic on Halloween night, the students were housed in a holding cell at the Chittenden County Correctional Facility due to a lack of space at Act One, Moran said.”If an individual is deemed to be incapacitated and they are taken into protective custody, they are taken to Act One and evaluated by professional staff,” Bilodeau said. “What it comes down to is safety,” Moran said. “We’d rather see them safe in jail, than having them just go loose.” Moran said that the Act One program, located in downtown Burlington, screened 21 people on the night of Halloween. Out of those 21 people, 15 were students. Seven of the students attended UVM. The housing of inebriated students in jail cells can lead to hazardous situations. Moran said he has heard of intoxicated individuals getting into fights with law enforcement officers and other inmates, which inevitably leads to the person be?ing charged with a crime.”You could be in a cell with other people, quite a few other people. [The correctional facility officials] have been known to really have [intoxicated people] packed in at times,” Moran said. These types of situations are equally strenuous on correctional facility officials, said Moran.”The jail wants to be a jail and not a holding tank for drunk people,” Moran said. The economic woes facing Vermont – and the country as a whole – have people within the Howard Center, the agency that runs the Act One program, concerned for the future. “We are seriously concerned about cut backs from the state and the impact of the economy on foundation, business and individual giving,” Gail Rosenberg, who works for the Howard Center in public relations, said. According to information provided in ane-mail by Rosenberg, the Act One program is facing economic concerns over its ability to provide its services to the greater Burlington community. The Howard Center is Vermont’s 13th largest employer, with over 800 employees and over 400 contracted employees, Rosenberg said.Over the last five years, the total expenses for the Howard Center have increased roughly five percent. Rosenberg said that this increase would be greater if a staffing adjustment had not been implemented in 2008. In that same time period, revenues have averaged an increase of just over one percent. State grant funds have increased just more than two percent, which is less than half of the rate of increase for expenses.Rosenberg said the Howard Center relies on a mix of funding to stay afloat. The funding mix is made up of grants from the Alcohol and Drug Abuse Programs (ADAP) budget, which is under the control of the Department of Health; Medicaid coverage; personal health insurance coverage; funding from the United Way; the support of local colleges such as UVM; and various community donations. The funding provided to the Howard Center has not been sufficient enough in recent years to match the increase of expenses facing the agency, due to the state of the current economy. Linda Piasecki is the operations chief for the ADAP program under the Vermont Department of Health. Piasecki said that there are various factors that determine how much money is funneled into different programs. “It depends on the program and it depends on what our funding priorities are,” Piasecki said. “We tend to try to focus on direct treatment services. Those would be the kind of services that would be billable to Medicaid, for instance. We try to maintain those when we can.” Piasecki said that Act One is not considered to be a direct care system, but rather is grouped into a section of programs referred to as “public inebriates.” “Public inebriate is a little bit different because it’s not a clinical service,” Piasecki said. “When we give money for public inebriate it usually is not based on service units. It’s based usually on what they got the year before.” Act One has been provided with a $280,000 grant from ADAP, which has not fluctuated at all in the last five years. Bob Bick, the director of the Mental Health and Substance Abuse Services (MHSAS) wing of the Howard Center, said that the ADAP grants only cover the cost of screening. “We don’t get anything to cover the cost of actually sheltering the individual,” Bick said. “That’s where all the community contributions: United Way, Fletcher Allen and other community members make direct contributions.”Bick doesn’t view the problem as stemming from the way ADAP chooses to allocate its limited funds. “The people at ADAP understand the challenges,” Bick said. “They just don’t have the money to give out.” Moran views the economy as the main factor challenging Act One’s ability to house patients. “The hard part is that there are many plans and no money,” Moran said. “If you look at the economy, it’s getting tighter and tighter.” Bick said part of the problem is the stigma attached to people dealing with substance abuse problem. “Getting politicians and policy makers to allocate money when there’s not a lot of money to a population that’s not particularly sympathetic, it’s a challenge,” Bick said.Bick said that the public inebriate program has been underfunded since its conception in the 1970s, when the state of Vermont passed the laws it has in place now for public drunkenness. “Politicians and policymakers always talk about doing more with less,” Bick said. “Well, I can tell you I’ve been a provider for 30 years, and the only thing you do with less is less.” Moran said that the Act One program plays a largely important role in the community not just for the civilians, but also in terms of relieving the local hospitals. “If we weren’t doing what we’re doing, every single drunk person we see according to state laws would end up having to go to an emergency room. That’s like 240 people a month that would end up in an emergency room, which wouldn’t be too pretty,” Moran said. “In this school year [UVM Police] have had roughly 60 ‘detoxes’, the vast majority of these folks are affiliated UVM students,” Bilodeau said.Bilodeau said that UVM averages about 100 “detoxes” cases a year. Moran said if he were to be provided with more funding, he would use it to “enhance services, meaning more beds.” He said there are currently plans in action to help enhance the services provided by Act One.Bick said that although times are hard, he is reminded of why his job in the community is important when he receives gracious feedback from former patients. “The grace of the program is that every once in a while, somebody will stop by or send a note and say ‘I just want to thank you for being here,'” Bick said.